Alayna Rice
Medical biller/coder
HAVRE DE GRACE,MD
Summary
Dynamic Medical Billing Manager with a proven track record at Prashant Shukla, MD, enhancing revenue cycle management and reducing claim denials through meticulous coding and compliance. Expert in ICD-10 coding and denial management, fostering team efficiency and patient satisfaction with exceptional communication skills.
Overview
2014
2014
years of professional experience
Work History
Medical Biller and Coder
Sang W Kim, MD
- Processed medical claims accurately to ensure timely reimbursement and minimize denials.
- Utilized coding manuals and software to assign correct codes for diagnoses and procedures.
- Reviewed patient charts for completeness, ensuring documentation met compliance standards.
- Coordinated with healthcare providers to resolve billing discrepancies and improve claim accuracy.
- Maintained up-to-date knowledge of billing regulations and coding guidelines to enhance service quality.
- Trained new staff members on coding practices and billing procedures, fostering team efficiency.
- Implemented process improvements that streamlined workflows, reducing turnaround times for claims processing.
- Conducted audits of submitted claims, identifying areas for improvement in documentation practices.
- Reduced claim denials through meticulous verification of patient eligibility and coverage benefits prior to claim submission.
- Worked closely with physicians to accurately assign ICD-10 diagnostic codes for optimal reimbursement rates from insurance companies.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
Medical Biller and Coder
D & J Medical
2011.02 - 2013.07
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Played a pivotal role in maintaining positive cash flow within the organization by ensuring timely submission of clean claims and diligent follow-ups on outstanding payments.
- Contributed to team efficiency by maintaining organized records of patient accounts, billing statements, and payment statuses.
- Expedited payment processing by promptly addressing any discrepancies or issues raised by insurance carriers.
Medical Billing Manager
Prashant Shukla, MD
2003.02 - 2010.03
- Oversaw all aspects of medical billing operations, ensuring compliance with regulations and policies.
- Developed training programs for staff on billing software and coding standards to enhance efficiency.
- Implemented quality control measures to improve accuracy of claims submissions and reduce denials.
- Analyzed billing data to identify trends, enhancing revenue cycle management strategies.
- Collaborated with healthcare providers to resolve billing discrepancies and improve patient satisfaction.
- Led initiatives to streamline workflows, resulting in optimized billing processes and reduced turnaround time.
- Managed relationships with insurance companies to ensure timely payments and resolution of issues encountered.
- Reviewed billing problems, researched issues, and resolved concerns.
- Worked with customers to develop payment plans and bring accounts current.
- Increased patient satisfaction by addressing billing inquiries promptly and professionally.
Office Manager
Sang W Kim, MD
1995.07 - 2000.07
- Managed office operations, ensuring smooth workflow and efficient scheduling.
- Coordinated patient appointments and maintained accurate medical records.
- Implemented improvements to filing systems, enhancing document retrieval efficiency.
- Trained new administrative staff on office procedures and software usage.
- Oversaw supply inventory, reducing costs through effective vendor negotiation.
- Developed office policies that improved patient communication and satisfaction.
- Streamlined billing processes, ensuring timely payments and accurate invoicing.
- Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.
- Provided exceptional customer service when addressing client inquiries or concerns via phone calls or email correspondence.
- Maintained accurate financial records by reconciling accounts payable/receivable transactions regularly to ensure balanced budgets.
Education
Medical Biller/Coder - Medical Billing/Coding
Ashford University
San Diego, CAMedical Billing/Coding - Medical Billing/Coding
Penn Foster Career School
Scranton, PASkills
HIPAA compliance
Payment posting
Insurance verification
ICD-10 proficiency
CMS-1500 form completion
Patient account management
Medicare and medicaid billing
Claim submission
Medical coding expertise
Diagnostic coding
Appeals processing
Procedural coding
Commercial insurance billing
Revenue cycle management
Workers' compensation billing
Denial management
CPT coding
Disability claims process
HCPCS level II coding
Medical billing procedures
Anatomy and physiology
Claims processing
Data entry
Medical terminology
Medical billing
Insurance claims analysis
Medical claims coding
Document management
Coding error resolution
Insurance coding (ICD-9 and CPT)
Data security procedures
Clinical documentation
Patient data compilation
Documentation oversight
Data verification
Records management
Performance improvement
Record assessment
Medical coding and abstracting
Healthcare claim coding
Coding appeals
Ethical standards
Medicare insurance regulations
Code assignment research
Statement analysis
Patient data identification
Data entry and management
Error reporting
Doctor communication
Customer service
Attention to detail
Records review
Electronic filing system organization
EMR systems
Insurance and coding specialist
Certified medical coder
Insurance billing
ICD 9 coding
Records scanning
Billing procedures
Patient information verification
Appointment scheduling
Electronic health record specialist
Past due account management
Records maintenance
Certified coding specialist
Medical billing code accuracy
Workers' compensation forms
ICD-10 coding
Certified coding specialist - physician - based
Renewing Physician Credentials with Insurance Companies
Timeline
Medical Biller and Coder
D & J Medical
2011.02 - 2013.07
Medical Billing Manager
Prashant Shukla, MD
2003.02 - 2010.03
Office Manager
Sang W Kim, MD
1995.07 - 2000.07
Medical Biller and Coder
Sang W Kim, MD
Medical Biller/Coder - Medical Billing/Coding
Ashford University
Medical Billing/Coding - Medical Billing/Coding
Penn Foster Career School